Pediatric CCRN Exam Cheat Sheet 2026

The 30 highest-yield Pediatric CCRN Exam facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which opioid is CONTRAINDICATED in a child with renal failure requiring pain management in the PICU? → Meperidine
2. A neonate post-cardiac surgery has a central venous pressure of 18 mmHg, decreased urine output, and hepatomegaly. These findings are MOST consistent with: → Right ventricular failure
3. Which acid-base disturbance progression is most commonly observed as chronic kidney disease (CKD) advances in children? → Non-anion gap metabolic acidosis progressing to elevated anion gap metabolic acidosis
4. The nurse's initial step in treating a patient who has hypovolemic shock as a result of persistent vomiting should be to: → Administer oxygen
5. When calculating percent fluid overload in a PICU patient, which formula is correct? → (Current weight − admission weight) / admission weight × 100
6. Which of the subsequent interventions would be most beneficial in helping to manage a child who needs PEEP of 14 cm water? → High-frequency oscillatory ventilation (HFOV)
7. Which of the following describes the fat embolism syndrome (FES)'s most typical showing feature in children? → Pulmonary manifestations
8. Which of these is a sign of leukemia? → Anemia infection
9. In a child with acute hypoxemic respiratory failure, which oxygenation index (OI) value meets criteria for pediatric ARDS (PARDS)? → OI of 10
10. Which corticosteroid dose is recommended for physiologic stress dosing (adrenal insufficiency coverage) in a critically ill child under 10 kg? → Hydrocortisone 50 mg/m² /day (stress dose: 3–5× maintenance)
11. What does the air lack in terms of breathing? → Respiratory arrest
12. A 5-year-old post-extubation develops stridor and increased work of breathing within 1 hour. The MOST appropriate initial intervention is: → Racemic epinephrine nebulization and IV dexamethasone
13. Which of the following would cause a newborn who had recently undergone cardiac surgery to lose more fluid without being aware of it and develop hypovolemia? → Radiant warmer use
14. A 4-year-old presents with bloody diarrhea, thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury. What is the most likely diagnosis? → Hemolytic uremic syndrome
15. In which clinical situation is the use of NSAIDs MOST dangerous and contraindicated due to risk of precipitating AKI in children? → Septic shock with hypotension
16. After taking prenatal vitamins with iron, a 5-year-old is receiving treatment in the PICU. The nurse assumes all of the following EXCEPT: → Administration of activated charcoal
17. Which medication class is the FIRST-LINE treatment for hypertensive emergency in a child with acute glomerulonephritis? → Calcium channel blockers (nicardipine IV)
18. A patient with heart failure who has bronchopulmonary dysplasia (BPD) is admitted. The nurse should prepare to administer interventions to ______. → Decrease Preload
19. What is the correct formula for estimated endotracheal tube size (uncuffed) in a child over 2 years of age? → (Age in years / 4) + 4
20. In a patient with bronchopulmonary dysplasia (BPD), which ventilatory parameters should be tapered down first? → Oxygen (FiO2) and peak inspiratory pressure (PIP)
21. A patient is admitted who is incapable of understanding English. Some recommendations for employing a translator include? → Standing next to the translator and as close to the patient as possible.
22. Which of the following group of children might have a hypertensive crisis as shown by acidosis, hypothermia, and alveolar hypoxia? → Those with reactive pulmonary vascular bed
23. What does a Qp:Qs ratio greater than 2:1 indicate in a child with a cardiac shunt? → Significant left-to-right shunting requiring intervention
24. Which of the following graft types is frequently derived from cadaver skin and is frequently utilized in the treatment of pediatric burn wounds? → Allograft
25. Which congenital heart defect produces a continuous 'machinery' murmur best heard at the left upper sternal border? → Patent ductus arteriosus
26. A child with AKI has a serum sodium of 122 mEq/L and is actively seizing. What is the most appropriate immediate intervention? → 3% hypertonic saline bolus
27. Which of the following observations supports the assertion that a 6-month-old has brain death? → Absence of spontaneous breathing when PaCO2 goes above 60 mmHg
28. A child with bacterial meningitis develops the sudden onset of a fixed dilated pupil and posturing. The nurse should FIRST: → Notify the physician immediately and prepare for emergent ICP management
29. Which of the following variables will cause the oxyhemoglobin dissociation curve to shift to the right and have a negative effect? → Hyperthermia
30. What is the RECOMMENDED head-of-bed position for a child with elevated ICP and no spinal injury? → 15–30 degree elevation to promote venous drainage